Provider Demographics
NPI:1477684553
Name:VAUGHN, LARITHA (CAS II, MA, MFTI)
Entity Type:Individual
Prefix:
First Name:LARITHA
Middle Name:
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:CAS II, MA, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-0051
Mailing Address - Country:US
Mailing Address - Phone:323-419-7384
Mailing Address - Fax:
Practice Address - Street 1:14020 ORIZABA AVE
Practice Address - Street 2:4
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-6124
Practice Address - Country:US
Practice Address - Phone:323-419-7384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA80054106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor